Progress in single-incision laparoscopic surgery for gastric cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LI Guoxin

Department of General Surgery, Southern Hospital, Southern Medical University, Guangzhou 510515, P. R. China;

Corresponding author：

LI Guoxin, Email: gzliguoxin@163.com

Keywords：

gastric cancer; single-incision; laparoscope; minimally invasive surgery

DOI：

10.7507/1007-9424.202310003

Video：

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With the upgrading of minimally invasive surgical concepts and laparoscopic equipment for gastric cancer, single-incision laparoscopic surgery (SILS) had emerged as a new focus of research in gastric cancer surgery. SILS offered advantages such as reduced damage, superior cosmetic outcomes, decreased postoperative pain, and faster recovery as compared with traditional laparoscopic gastrectomy. However, its level of difficulty limited its further promotion and application. Although numerous studies supported the safety and feasibility of SILS, more high-level evidence-based medical research was required to endorse its widespread use. The author reviewed the development history, current status, and prospects of SILS laparoscopic gastric cancer surgery.

Citation： LI Guoxin. Progress in single-incision laparoscopic surgery for gastric cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(10): 1169-1172. doi: 10.7507/1007-9424.202310003 Copy

1.	Yu J, Huang C, Sun Y, et al. Effect of laparoscopic vs open distal gastrectomy on 3-year disease-free survival in patients with locally advanced gastric cancer: the CLASS-01 randomized clinical trial. JAMA, 2019, 321(20): 1983-1992.
2.	Hu Y, Huang C, Sun Y, et al. Morbidity and mortality of laparoscopic versus open D2 distal gastrectomy for advanced gastric cancer: a randomized controlled trial. J Clin Oncol, 2016, 34(12): 1350-1357.
3.	Liu F, Huang C, Xu Z, et al. Morbidity and mortality of laparoscopic vs open total gastrectomy for clinical stage i gastric cancer: the CLASS02 Multicenter randomized clinical trial. JAMA Oncol, 2020, 6(10): 1590-1597.
4.	Son SY, Hur H, Hyung WJ, et al. Laparoscopic vs open distal gastrectomy for locally advanced gastric cancer: 5-year outcomes of the KLASS-02 randomized clinical trial. JAMA Surg, 2022, 157(10): 879-886.
5.	Chen XH, Hu YF, Luo J, et al. The safety of esophagojejunostomy via a transorally inserted-anvil method vs extracorporeal anastomosis using a circular stapler during total gastrectomy for Siewert type 2 adenocarcinoma of the esophagogastric junction. Gastroenterol Rep (Oxf), 2019, 8(3): 242-251.
6.	Chen Y, Yang Z, Zhao M, et al. Impact of preoperative therapy on surgical outcomes of laparoscopic total gastrectomy for gastric/gastroesophageal junction cancer. Chin J Cancer Res, 2023, 35(4): 354-364.
7.	Omori T, Oyama T, Akamatsu H, et al. Transumbilical single-incision laparoscopic distal gastrectomy for early gastric cancer. Surg Endosc, 2011, 25(7): 2400-2404.
8.	Kim SM, Ha MH, Seo JE, et al. Comparison of reduced port totally laparoscopic distal gastrectomy (Duet TLDG) and conventional laparoscopic-assisted distal gastrectomy. Ann Surg Oncol, 2015, 22(8): 2567-2572.
9.	Kawamura H, Tanioka T, Shibuya K, et al. Comparison of the invasiveness between reduced-port laparoscopy-assisted distal gastrectomy and conventional laparoscopy-assisted distal gastrectomy. Int Surg, 2013, 98(3): 247-253.
10.	Kunisaki C, Miyamoto H, Sato S, et al. Surgical outcomes of reduced-port laparoscopic gastrectomy versus conventional laparoscopic gastrectomy for gastric cancer: a propensity-matched retrospective cohort study. Ann Surg Oncol, 2018, 25(12): 3604-3612.
11.	Karthik S, Augustine AJ, Shibumon MM, et al. Analysis of laparoscopic port site complications: a descriptive study. J Minim Access Surg, 2013, 9(2): 59-64.
12.	Park DJ, Lee JH, Ahn SH, et al. Single-port laparoscopic distal gastrectomy with D1+β lymph node dissection for gastric cancers: report of 2 cases. Surg Laparosc Endosc Percutan Tech, 2012, 22(4): e214-e216.
13.	中国医师协会微无创专业委员会外科单孔学组. 单孔加一腹腔镜胃癌手术操作专家共识(2020版). 腹腔镜外科杂志, 2021, 26(1): 7-12.
14.	Kong J, Wu SD, Su Y. Translumenal single-incision laparoscopy radical gastrectomy with D2 lymph node dissection for early gastric cancer--primary experience with less invasive surgery in China. J Laparoendosc Adv Surg Tech A, 2013, 23(2): 141-145.
15.	Suh YS, Park JH, Kim TH, et al. Unaided stapling technique for pure single-incision distal gastrectomy in early gastric cancer: Unaided Delta-shaped anastomosis and uncut Roux-en-Y anastomosis. J Gastric Cancer, 2015, 15(2): 105-112.
16.	Kim SM, Lee SH, Ha MH, et al. Techniques of the single-port totally laparoscopic distal gastrectomy. Ann Surg Oncol, 2015 Dec: 22 Suppl 3: S341. doi: 10.1245/s10434-015-4839-y.
17.	Ertem M, Ozveri E, Gok H, et al. Single incision laparoscopic total gastrectomy and D2 lymph node dissection for gastric cancer using a four-access single port: the first experience. Case Rep Surg, 2013, 2013: 504549.
18.	Ahn SH, Park DJ, Son SY, et al. Single-incision laparoscopic total gastrectomy with D1+β lymph node dissection for proximal early gastric cancer. Gastric Cancer, 2014, 17(2): 392-396.
19.	Lin T, Mou TY, Hu YF, et al. Reduced port laparoscopic distal gastrectomy with D2 lymphadenectomy. Ann Surg Oncol, 2018, 25(1): 246.
20.	林填, 余江, 胡彦锋, 等. 两孔法腹腔镜远端胃癌根治术的初步经验. 中华胃肠外科杂志, 2019, 22(1): 35-42.
21.	林填, 陈新华, 胡彦锋, 等. 单孔加一孔腹腔镜与传统五孔腹腔镜远端胃癌D2根治术安全性对比的倾向性得分匹配分析. 腹部外科, 2022, 35(6): 402-407.
22.	林填, 胡彦锋, 余江等. 单孔+1腹腔镜全胃切除、D2淋巴结清扫术. 中华普外科手术学杂志(电子版), 2021, 15(2): 143.
23.	Chen XH, Lin T, Huang H, et al. Application value of Overlap guiding tube (OGT) in assisting Overlap esophagojejunostomy during laparoscopic total gastrectomy for gastric/gastroesophageal junction (G/GEJ) tumors. Gastric Cancer, 2022, 25(4): 827-836.
24.	Chen XH, Huang HL, Li GX, et al. ASO author reflections: OGT-assisted method made the Overlap esophagojejunostomy in laparoscopic total gastrectomy easier. Ann Surg Oncol, 2023, 30(5): 2739-2740.
25.	Chen XH, Lin T, Zhao ML, et al. ASO visual abstract: safety and efficacy of OGT-assisted Overlap oesophagojejunostomy versus traditional Overlap method in laparoscopic total gastrectomy for gastric/gastroesophageal junction (G/GEJ) tumours. Ann Surg Oncol, 2023, 30(5): 2741-2742.
26.	Chen X, Lin T, Zhao M, et al. Safety and efficacy of OGT-assisted Overlap oesophagojejunostomy versus the traditional Overlap method in laparoscopic total gastrectomy for gastric/gastroesophageal junction (G/GEJ) tumours. Ann Surg Oncol, 2023, 30(5): 2729-2738.
27.	陈新华, 胡彦锋, 林填, 等. Overlap引导管在腹腔镜全胃切除Overlap食管空肠吻合术中的应用价值. 中华消化外科杂志, 2022, 21(1): 99-105.
28.	陈新华, 李国新, 张驰, 等. 胃癌围手术期并发症. 中华胃肠外科杂志, 2023, 26(2): 160-166.
29.	Omori T, Fujiwara Y, Moon J, et al. Comparison of single-incision and conventional multi-port laparoscopic distal gastrectomy with D2 lymph node dissection for gastric cancer: a propensity score-matched analysis. Ann Surg Oncol, 2016, 23(Suppl 5): 817-824.
30.	Lee B, Youn SI, Lee K, et al. Comparing the short-term outcomes and cost between solo single-incision distal gastrectomy and conventional multiport totally laparoscopic distal gastrectomy for early gastric cancer: a propensity score-matched analysis. Ann Surg Treat Res, 2021, 100(2): 67-75.
31.	杨波. 经脐单孔腹腔镜与传统五孔腹腔镜胃癌D2根治术治疗早期胃癌患者的效果比较. 中国民康医学, 2020, 32(22): 115-117.
32.	王家兴, 黄隆锴, 何庆良. 单孔腹腔镜胃窦癌根治术对患者围手术期免疫功能的影响. 中华实验外科杂志, 2019, 36(7): 1295-1298.

1. Yu J, Huang C, Sun Y, et al. Effect of laparoscopic vs open distal gastrectomy on 3-year disease-free survival in patients with locally advanced gastric cancer: the CLASS-01 randomized clinical trial. JAMA, 2019, 321(20): 1983-1992.
2. Hu Y, Huang C, Sun Y, et al. Morbidity and mortality of laparoscopic versus open D2 distal gastrectomy for advanced gastric cancer: a randomized controlled trial. J Clin Oncol, 2016, 34(12): 1350-1357.
3. Liu F, Huang C, Xu Z, et al. Morbidity and mortality of laparoscopic vs open total gastrectomy for clinical stage i gastric cancer: the CLASS02 Multicenter randomized clinical trial. JAMA Oncol, 2020, 6(10): 1590-1597.
4. Son SY, Hur H, Hyung WJ, et al. Laparoscopic vs open distal gastrectomy for locally advanced gastric cancer: 5-year outcomes of the KLASS-02 randomized clinical trial. JAMA Surg, 2022, 157(10): 879-886.
5. Chen XH, Hu YF, Luo J, et al. The safety of esophagojejunostomy via a transorally inserted-anvil method vs extracorporeal anastomosis using a circular stapler during total gastrectomy for Siewert type 2 adenocarcinoma of the esophagogastric junction. Gastroenterol Rep (Oxf), 2019, 8(3): 242-251.
6. Chen Y, Yang Z, Zhao M, et al. Impact of preoperative therapy on surgical outcomes of laparoscopic total gastrectomy for gastric/gastroesophageal junction cancer. Chin J Cancer Res, 2023, 35(4): 354-364.
7. Omori T, Oyama T, Akamatsu H, et al. Transumbilical single-incision laparoscopic distal gastrectomy for early gastric cancer. Surg Endosc, 2011, 25(7): 2400-2404.
8. Kim SM, Ha MH, Seo JE, et al. Comparison of reduced port totally laparoscopic distal gastrectomy (Duet TLDG) and conventional laparoscopic-assisted distal gastrectomy. Ann Surg Oncol, 2015, 22(8): 2567-2572.
9. Kawamura H, Tanioka T, Shibuya K, et al. Comparison of the invasiveness between reduced-port laparoscopy-assisted distal gastrectomy and conventional laparoscopy-assisted distal gastrectomy. Int Surg, 2013, 98(3): 247-253.
10. Kunisaki C, Miyamoto H, Sato S, et al. Surgical outcomes of reduced-port laparoscopic gastrectomy versus conventional laparoscopic gastrectomy for gastric cancer: a propensity-matched retrospective cohort study. Ann Surg Oncol, 2018, 25(12): 3604-3612.
11. Karthik S, Augustine AJ, Shibumon MM, et al. Analysis of laparoscopic port site complications: a descriptive study. J Minim Access Surg, 2013, 9(2): 59-64.
12. Park DJ, Lee JH, Ahn SH, et al. Single-port laparoscopic distal gastrectomy with D1+β lymph node dissection for gastric cancers: report of 2 cases. Surg Laparosc Endosc Percutan Tech, 2012, 22(4): e214-e216.
13. 中国医师协会微无创专业委员会外科单孔学组. 单孔加一腹腔镜胃癌手术操作专家共识(2020版). 腹腔镜外科杂志, 2021, 26(1): 7-12.
14. Kong J, Wu SD, Su Y. Translumenal single-incision laparoscopy radical gastrectomy with D2 lymph node dissection for early gastric cancer--primary experience with less invasive surgery in China. J Laparoendosc Adv Surg Tech A, 2013, 23(2): 141-145.
15. Suh YS, Park JH, Kim TH, et al. Unaided stapling technique for pure single-incision distal gastrectomy in early gastric cancer: Unaided Delta-shaped anastomosis and uncut Roux-en-Y anastomosis. J Gastric Cancer, 2015, 15(2): 105-112.
16. Kim SM, Lee SH, Ha MH, et al. Techniques of the single-port totally laparoscopic distal gastrectomy. Ann Surg Oncol, 2015 Dec: 22 Suppl 3: S341. doi: 10.1245/s10434-015-4839-y.
17. Ertem M, Ozveri E, Gok H, et al. Single incision laparoscopic total gastrectomy and D2 lymph node dissection for gastric cancer using a four-access single port: the first experience. Case Rep Surg, 2013, 2013: 504549.
18. Ahn SH, Park DJ, Son SY, et al. Single-incision laparoscopic total gastrectomy with D1+β lymph node dissection for proximal early gastric cancer. Gastric Cancer, 2014, 17(2): 392-396.
19. Lin T, Mou TY, Hu YF, et al. Reduced port laparoscopic distal gastrectomy with D2 lymphadenectomy. Ann Surg Oncol, 2018, 25(1): 246.
20. 林填, 余江, 胡彦锋, 等. 两孔法腹腔镜远端胃癌根治术的初步经验. 中华胃肠外科杂志, 2019, 22(1): 35-42.
21. 林填, 陈新华, 胡彦锋, 等. 单孔加一孔腹腔镜与传统五孔腹腔镜远端胃癌D2根治术安全性对比的倾向性得分匹配分析. 腹部外科, 2022, 35(6): 402-407.
22. 林填, 胡彦锋, 余江等. 单孔+1腹腔镜全胃切除、D2淋巴结清扫术. 中华普外科手术学杂志(电子版), 2021, 15(2): 143.
23. Chen XH, Lin T, Huang H, et al. Application value of Overlap guiding tube (OGT) in assisting Overlap esophagojejunostomy during laparoscopic total gastrectomy for gastric/gastroesophageal junction (G/GEJ) tumors. Gastric Cancer, 2022, 25(4): 827-836.
24. Chen XH, Huang HL, Li GX, et al. ASO author reflections: OGT-assisted method made the Overlap esophagojejunostomy in laparoscopic total gastrectomy easier. Ann Surg Oncol, 2023, 30(5): 2739-2740.
25. Chen XH, Lin T, Zhao ML, et al. ASO visual abstract: safety and efficacy of OGT-assisted Overlap oesophagojejunostomy versus traditional Overlap method in laparoscopic total gastrectomy for gastric/gastroesophageal junction (G/GEJ) tumours. Ann Surg Oncol, 2023, 30(5): 2741-2742.
26. Chen X, Lin T, Zhao M, et al. Safety and efficacy of OGT-assisted Overlap oesophagojejunostomy versus the traditional Overlap method in laparoscopic total gastrectomy for gastric/gastroesophageal junction (G/GEJ) tumours. Ann Surg Oncol, 2023, 30(5): 2729-2738.
27. 陈新华, 胡彦锋, 林填, 等. Overlap引导管在腹腔镜全胃切除Overlap食管空肠吻合术中的应用价值. 中华消化外科杂志, 2022, 21(1): 99-105.
28. 陈新华, 李国新, 张驰, 等. 胃癌围手术期并发症. 中华胃肠外科杂志, 2023, 26(2): 160-166.
29. Omori T, Fujiwara Y, Moon J, et al. Comparison of single-incision and conventional multi-port laparoscopic distal gastrectomy with D2 lymph node dissection for gastric cancer: a propensity score-matched analysis. Ann Surg Oncol, 2016, 23(Suppl 5): 817-824.
30. Lee B, Youn SI, Lee K, et al. Comparing the short-term outcomes and cost between solo single-incision distal gastrectomy and conventional multiport totally laparoscopic distal gastrectomy for early gastric cancer: a propensity score-matched analysis. Ann Surg Treat Res, 2021, 100(2): 67-75.
31. 杨波. 经脐单孔腹腔镜与传统五孔腹腔镜胃癌D2根治术治疗早期胃癌患者的效果比较. 中国民康医学, 2020, 32(22): 115-117.
32. 王家兴, 黄隆锴, 何庆良. 单孔腹腔镜胃窦癌根治术对患者围手术期免疫功能的影响. 中华实验外科杂志, 2019, 36(7): 1295-1298.

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Progress in single-incision laparoscopic surgery for gastric cancer

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